AbstractHyponatremia is common in patients with cirrhosis. Portal hypertension, diuretics, large volume paracentesis without albumin, infection, and multiple medications are connected with the development or worsening of hyponatremia. Hyponatremia in cirrhosis, particularly advanced cirrhosis, is a common development.1 In a population survey of 997 patients with cirrhosis, 486 (49.4%) and 211 (21.6%) had a serum sodium concentration ([Na+]) <135 mEq/L and ≤130 mEq/L, respectively.2 Hyponatremia and its severity correlate with the presence of severe complications of cirrhosis such as hepatorenal syndrome, encephalopathy, and spontaneous bacterial peritonitis. The presence of hyponatremia frequently complicates the management of the cirrhotic patient. Journal of Hospital Medicine 2012; 7:S14–S17. © 2012 Society of Hospital Medicine